{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:56:55Z","timestamp":1777939015885,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In patients with renal hyperparathyroidism the choice of surgery varies between total parathyroidectomy with autotransplantation (TPTx\u2009+\u2009AT) and subtotal parathyroidectomy (SPT) with variable outcomes. The present study investigated the risk of extracervical recurrences in patients who underwent total parathyroidectomy with autotransplantation for dialysis patients with renal hyperparathyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort analysis of patients who underwent TPTx\u2009+\u2009AT for renal hyperparathyroidism between the years 2000 and 2023 at a tertiary referral hospital. Patient demographic profiles, biochemical and surgical data, incidence of recurrence and outcomes of intervention were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Some 142 (71M:71\u2009F) patients with a mean age of 58.6\u2009\u00b1\u200911.2\u2009years underwent total parathyroidectomy and autotransplantation during the study period. The mean dialysis vintage was 6.3\u2009\u00b1\u20093.2\u2009years. Extracervical recurrence was seen in 25 (17.6%) of 142 patients, after a mean follow-up of 9 (\u00b14.2) years, with the common sites of recurrence being the deltoid autotransplant site (73.1%) and the mediastinum (11.5%), while 7.7% of recurrences were biochemical with no localized site. Of the recurrences, 19 of 25 (76%) underwent explant of the deltoid autotransplant, and two in the mediastinum underwent minimally invasive excision (one video assisted thoracic surgery and one robotic excision) of the parathyroid lesion. The median parathyroid hormone level at the time of recurrence was 109.4\u2009pg\/ml compared with 17.2\u2009ng\/L postexcision or explantation. The only factor predictive for recurrences in the cohort on multivariable analysis was postoperative serum PTH (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). Log-rank test showed no statistically significant difference in survival between the two groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.355).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Extracervical recurrences in the autotransplant are not uncommon in the long-term following total parathyroidectomy and autotransplantation for patients with renal hyperparathyroidism. These recurrences need explantation or excision to reduce the PTH burden in patients who cannot avail a renal transplant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969251363333","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T16:13:59Z","timestamp":1760804039000},"page":"97-105","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of extracervical recurrence following total parathyroidectomy and autotransplantation for renal hyperparathyroidism"],"prefix":"10.1177","volume":"115","author":[{"given":"Dan","family":"Cortes","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery, National University Hospital, Singapore"},{"name":"Division of Surgery, Cebu Doctors\u2019 University Hospital, Cebu, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujith","family":"Wijerethne","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, National University Hospital, Singapore"},{"name":"Department of Surgery, Alexandra Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, National University Hospital, Singapore"},{"name":"Department of Surgery, Alexandra Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph V.","family":"Yap","sequence":"additional","affiliation":[{"name":"Division of Surgery, Cebu Doctors\u2019 University Hospital, Cebu, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngiam K.","family":"Yuan","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, National University Hospital, Singapore"},{"name":"Department of Surgery, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3318-0357","authenticated-orcid":false,"given":"Rajeev","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Assistant Professor, Senior Consultant Division of Endocrine Surgery National University Hospital Singapore 119074 Singapore"},{"name":"Department of Surgery Alexandra Hospital Singapore"},{"name":"Department of Surgery National University of Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00894.x"},{"key":"e_1_3_2_3_2","volume":"76","author":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)","year":"2009","unstructured":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl 2009;76:S1\u2013130.","journal-title":"Kidney Int Suppl"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2015195"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000414"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.308"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2018.08.046"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2022.121148"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12801"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1169793"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0531-3"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.12.019"},{"issue":"1","key":"e_1_3_2_13_2","first-page":"34","article-title":"Transplantation of the parathyroid glands in man: Clinical indications and results","volume":"78","author":"Wells SA","year":"1975","unstructured":"Wells SAJr., Gunnells JC, Shelburne JD, et al: Transplantation of the parathyroid glands in man: Clinical indications and results. Surgery 1975;78(1):34\u201344.","journal-title":"Surgery"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.06.029"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.11.005"},{"key":"e_1_3_2_16_2","first-page":"665","article-title":"Parathyreoidektomie und Autotransplantation beim renalen Hyperparathyreoidismus. I. Klinische und Laborchemische Untersuchungen zur Gewebeauswahl","volume":"60","author":"Niederle B","year":"1989","unstructured":"Niederle B, H\u00f6randner H, Roka R, et al: Parathyreoidektomie und Autotransplantation beim renalen Hyperparathyreoidismus. I. Klinische und Laborchemische Untersuchungen zur Gewebeauswahl. Chirurg 1989;60:665\u2013670.","journal-title":"Chirurg"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1776-7"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005522"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1344-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2024.11.013"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1159\/000073014"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200205000-00009"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.08.014"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-19-0284"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000009050"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.01.019"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.102370"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2017.1363779"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.27432"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.04.027"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0412-9"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900524"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010220"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-2091-9"},{"issue":"7","key":"e_1_3_2_35_2","first-page":"385","article-title":"The role of cervical thymectomy in surgical treatment of secondary hyperparathyroidism","volume":"112","author":"Uludag M","year":"2011","unstructured":"Uludag M, Yetkin G, Citgez B, et al: The role of cervical thymectomy in surgical treatment of secondary hyperparathyroidism. Bratisl Lek Listy 2011;112(7):385\u2013389.","journal-title":"Bratisl Lek Listy"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2018.10.010"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrab151"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-015-0410-8"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969251363333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14574969251363333","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969251363333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:00:16Z","timestamp":1777698016000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14574969251363333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,18]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/14574969251363333"],"URL":"https:\/\/doi.org\/10.1177\/14574969251363333","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,18]]}}}